Contraceptive practices among married women of reproductive age in Bangladesh: a review of the evidence

Background: Bangladesh has experienced a sevenfold increase in its contraceptive prevalence rate (CPR) in less than forty years from 8% in 1975 to 62% in 2014. However, despite this progress, almost one-third of pregnancies are still unintended which may be attributed to unmet need for family planning and discontinuation and switching of methods after initiation of their use. Methods: We conducted an extensive literature review on contraceptive use among married women of reproductive age (MWRA) in Bangladesh. A total of 263 articles were identified through database search and after final screening ten articles were included in this synthesis. Results: Findings showed that method discontinuation and switching, method failure, and method mix may offset achievements in the CPR. Most of the women know of at least one contraceptive method. Oral pill is the most widely used (27%) method, followed by injectables (12.4%), condoms (6.4%), female sterilization (4.6%), male sterilization (1.2%), implants (1.7%), and IUDs (0.6%). There has been a decline in the use of long acting and permanent methods over the last two decades. Within 12 months of initiation, the rate of method discontinuation particularly the short-acting methods remain high at 36%. It is important to recognize the trends as married Bangladeshi women, on average, wanted 1.6 children, but the rate of actual children was 2.3. Conclusions: A renewed commitment from government bodies and independent organizations is needed to implement and monitor family planning strategies in order to ensure the adherence to and provision of the most appropriate contraceptive method for couples.